Always take your vitamin supplements using combinations excluding "B" vitamins. Then you can take other inputs of "B" without any problems.

Why not take just one daily multi-vitamin with everything?

Because most people will easily take enough "B" vitamins in their diet. Any excess will just be flushed away. What a waste.

(BTW many multivitamin preps have a reduced level of vitamin "A" to make them safe with other supplements.)

In normal health and with a normal balanced diet vitamin supplements are a waste of cupboard space. Having said that, I use 1g dispersible vitamin "C" drink each night to wash down my prescription meds, with an an extra multivitamin (A-reduced) for luck. And I know you believe in luck, Rick! I haven't had a cold for as long as I can remember, even when my granddaughter (who was at nursery from 6 months old) came with a cold almost every week for her first 5 years. I can never remember having influenza.

Can you cite a study showing taking B-Vitamins results in any meaningful amounts being excreted? I don't think most people get enough (not simply enough to prevent a deficiency but to have health benefits) of their essential nutrition from diet alone.

Many compounds don't get metabolized and are excreted intact, however it has no bearing on it having no effect or being a waste.

I agree, using the argument- why take more vitamins if they are just going to be excreted?- seems to be pharmacological double standards. The case is also true that if you take more methamphetamine, you excrete more methamphetamine, and we all know what happens when you take more methamphetamine....

Let's look at a simple description of the metabolism of water soluble vitamins ("vitamin." Encyclopædia Britannica. 2009. Encyclopædia Britannica Online. 10 Feb. 2009):

Water-soluble vitamins usually are excreted in the urine of humans. Thiamin, riboflavin, vitamin B6, vitamin C, pantothenic acid, and biotin appear in urine as free vitamins (rather than as coenzymes); however, little free niacin is excreted in the urine. Products (also called metabolites) that are formed during the metabolism of thiamin, niacin, and vitamin B6 also appear in the urine. Urinary metabolites of biotin, riboflavin, and pantothenic acid also are formed. Excretion of these vitamins (or their metabolites) is low when intake is sufficient for proper body function. If intake begins to exceed minimal requirements, excess vitamins are stored in the tissues. Tissue storage capacity is limited, however, and, as the tissues become saturated, the rate of excretion increases sharply. Unlike the other water-soluble vitamins, however, vitamin B12 is excreted solely in the feces. Some folic acid and biotin also are normally excreted in this way.

That's a very general statement. Perhaps you could firm it up with some scientific evidence to indicate that there are your implied "health benefits" from taking levels of "B" vitamins over those required to prevent deficiency.

Eh? What's that got to do with paying for aggressively marketed supplements with the implication that are they beneficial to naive healthy individuals who do not necessarily need them. Those individuals would be better advised to improve their diets and would then obtain all of the essential nutrients and micronutrients along with the essential roughage that really is in short supply in the modern processed food menu.

So you are saying that even if there is no indication for a dietary supplement, one should still take them, even though there is evidence that excess over normal requirements is excreted (and is thus a waste of time and money)? Your methamphetamine example does not support the case for taking an excess of essential nutritional factors that are found in sufficient quantities in a typical diet, but when the required intake level is exceeded provide no extra nutritional or metabolic advantage. (Recommended intake levels can be found here: http://ods.od.nih.gov/Health_Information/I...pplements.aspx)

The benefits of many supplemented dietary components, including vitamins, over and above the intake from a balanced diet, are often shown to be not conclusive and are on occasions even harmful. With respect to the "B" vitamins, niacin >100mg can impair liver function. Who knows what the intake levels are of OTC products taken by self-dosing members of the general public? Have you seen the font size on some of the OTC bottles, labels and datasheets (if included)? But I'm not really trying to say that vitamin overdosing is a great toxicological problem; rather, that a lot of money is going down the drain (often literally). And, of course, there are instances of clinical illness due to vitamin deficiency (e.g. B12 impaired absorption with possible required cyanocobalamin therapy), or where clinical recommendations for a temporary increase in intake levels are appropriate (esp B6 - folate).

So I guess the old saying "An apple a day keeps the doctor away" (Ben Franklin) might be true. I think exercise is the most important way to maintain health. It makes you hungry, which helps to assure a good diet (in knowlegeable people).

Not much in an apple, unfortunately. But a good way for primitive humans to obtain clean water (with a few minerals and a bit of roughage thrown in) and clean their teeth. However, the principle is sound. But watch those high acid fruits as they dissolve tooth enamel. Certainly one should give one's teeth a recovery period of about 20 minutes after eating citrus fruits or drinking fruit juice. (And even more time after a coke - hence the phrase, "There's no rest for the wicked!"

No, I was arguing for a more fundamental principle and not arguing for either the positives or negatives of supplements. I was trying to say that excretion has a complex relationship with efficacy and just because we excrete a lot of something, doesn't mean that it's not being used on its way out even if it is excreted unchanged. The methamphetamine example was to point this out. As this is a supplement forum, let's take magnesium. Even though taking lots of magnesium will result in most of it being excreted, taking lots will lead to an acute state of confusion/delirium presumably through interactions with nmda receptors. Just 'cause its being excreted doesn't mean its not doing anything.

I don't trust that recommended levels of intake are guided by best evidenced based medicine for optimum intake, and are at said suggested levels only to prevent noticeable disease.

As to the finer points of vitamin supplementation, eh... I don't take them much, usually only after a heavy weekend and I haven't noticed any change in my physical health from taking them or not taking them.

But we are talking here about the B vitamins where there is a well understood, and quite widely accepted level of intake for normal health. Over that level, although most are not hazardous, there is little, if any evidence (except in certain clinical instances as described earlier) of added benefits. So what is the point in taking them? The other examples you give are not relevant as the pharmacology or toxicology is quite different (maybe niacin is similar wrt the latter).

To reiterate, there is little evidence for most B vitamins that there is added benefit from taking levels above those recommended levels (except for the reasons given above). If you are privy to firm evidence, then do let me know.

So you have wasted you money on supplements, for which there is little or no evidence for added benefit over the recommended levels, at least specifically for the present case of B vitamins (that you probably ingest through your normal diet), unless you are pregnant.


I was looking forward to a solid scientific discussion, with empirical evidence as the central foundation, in this new sub-board, avoiding vested interests, anecdotes and the like. As astrology is to astronomy ...

Not a study. The effects of any chemical is unique and can not be generalized. There is a difference between taking a compound in amounts to prevent a deficiency, provide health benefits, and in excess.



As general as yours, however mine is based on experience. I've had 1,000's of patients and reviewed their diets many people to not get enough nutrition from diet alone.That's a fact. List your own diet if you like and let's see if you get all the essential nutrition you need on a daily basis. I would suggest you review the health benefits of Pyridoxamine and Benfotiamine to name a few. Or the effects of various B-Vitamins in preventing elevated levels of homocystiene.



You seem confused as your response has nothing to do with my statement. You seem to think if something does not get metabolized is a waste that is simply untrue. If people want to help prevent disease diet alone will not be enough.

Br J Nutr. 2008 Jun;99 Suppl 3:S48-54.
Intake and status of folate and related B-vitamins: considerations and challenges in achieving optimal status.
McNulty H, Scott JM.

Hmm. I think I am justified in taking a multivitamin. Here's my diet:

Breakfast: one slice of whole wheat toast with jam or marmalade, one cup of coffee with milk and white sugar, one multivitamin capsule.

Lunch: Whole wheat bread and meat (about 1.5 ounces) sandwich, one apple, oatmeal and raisin cookie, 12 ounce can of Coca-Cola.

Dinner: meat, pasta, boiled or baked vegetables (carrots, brocoli, grean beans, typically), cookie or cake. Grapefruit juice with water.

No coffee or soda outside of those listed with the meals. I mass a little over 100 kilograms, am 6' 2" tall, and lift weights and run daily. I'll be 60 years old this summer. There's some variety in my diet, but generally I will eat whatever's put in front of me. Nuts and corn chips for snacks sometimes. Red wine now and then. Martinis with friends on weekends sometimes (with green olive).

I have comments to make on the posts of LM and O when I have time. Suffice it to say here that I do not accept anecdotal evidence, nor do I accept that O has provided much over what I have already accepted in a clinical context (includes in pregnancy), as there is MUCH contrary evidence. I also await some actual evidence from LM who should be able to put fingers on it instantly if he actually prescribes B-vitamins as part of clinical treatments.

I await any research to support your comments.

What evidence are you referring to? My patients diet records to confirm many people do not get enough nutrition from diet alone? I don't share such information.

Nice diet and if you add up all the essential vitamins, minerals, and omega 3s you would not be getting everything you need to prevent a deficiency much less promote ideal health. I would agree that you and most americans are justified in taking supplements.

Do you incorporate Organic foods into your diet and would you be oppose to using unrefined sugars/grains?

Outragious and spectacular. I wish I could do that! AS everytime I get a cold (once a year in the winter) I get sinusitis as well, and I get sick as a puppy. For those not familiar with sinusitis, it is a very painful inflamation of the area around your eyes. I prefer to treat it with prolonged periods of rest, but I don't get a chance as I am a very active person. So I always have to resort to antibiotics, which I don't like.

I occasionally buy organic vegetables from the farmers' market in town and am not opposed to unrefined sugars/grains. I usually prefer whole grain bread and pasta for both taste and nutrition. I can't tell much difference with bleached versus unnbleached sugar.

I forgot to mention that I like raw spinach leaf, tomatoes, and such in salads with dinner.

Plenty of B2, B3, B6 and B9 in spinach. (B9, folate was first purified from spinach). And good for other vitamins too. But care with calculating the iron and calcium, as the oxalate content decreases absorption of these. So Rick, 200g of spinach a day could keep the need for vitamin-B tablets away!

Will it help him steal Olivia's heart away from Brutus' too, or is that just media hype?

I don't think I get 200 grams a day. That's almost half a pound!

Absolutely! It's great for the love life too.

Well, Popeye seemed to manage it!

Yea but what they don't tell you is how he popped his eye!

Trying to swallow a multivitamin tablet that got stuck?

Experience that = anecdotes as opposed to evidence and guidelines?

GUIDELINES FOR VITAMIN AND MINERAL FOOD SUPPLEMENTS
CAC/GL 55 - 2005
PREAMBLE
Most people who have access to a balanced diet can usually obtain all the nutrients they require
from their normal diet. Because foods contain many substances that promote health, people
should therefore be encouraged to select a balanced diet from food before considering any vitamin
and mineral supplement. In cases where the intake from the diet is insufficient or where
consumers consider their diet requires supplementation, vitamin and mineral food supplements
serve to supplement the daily diet.

http://www.codexalimentarius.net/web/index_en.jsp

And as anecdotal as your evidence might be, my background in this area come from a career as a biomedical scientist that began in 1971, culminating as a university academic from 1987 with related spin-out businesses in analytical cell biology. Quite specific to the topic, I hold a masters degree in medicinal chemistry. So as contrived as your comments are about my "general" approach, I hold that my qualification and experience is possibly better than your own when it comes to in-depth knowledge on the biochemistry and metabolism of vitamins and the interpretation of data related to this. Perhaps you could let us know the guidelines and regulations that you abide by when making recommendations on dietary supplements to patients who show no signs of deficiency.

Maybe we should just accept vitamin supplement use as a placebo and be done with it. Then we could get rich selling fake vitamins!

Top 5 most nutritous fruits in the world and why. Blueberry, cramberry, guava, kiwi and strawberry.
http://perfectshape.blogspot.com/2007/01/t...n-world_17.html

Those all taste fantastic too! Alternative, suck on a sweetened (usually artificially) vitamin tablet. (By the way, it's cranberry, unless in the US they grow so big you have to use a stick to get them down! )

Cranberries are too sour to eat. Bake them into muffins instead.

My problem here is finding guava. Very expensive and difficult to find. thank goodness my mom has a guava tree in her backyard! Yes! That's how close to the Ecuator I live! The problem is after they go off season. And guava juice is just not available out there yet.

Out where? I have several guava trees, and a guava forest.

Yea, bonsai size! You showed us the pictures, remember? LOL!!! But seriously, though, You can grow them in Cali, huh! So, they're not as rare as I thought! But what about when they're not in season? Can you find guava juice in your local grocery store? What brand?

You don't get cartons of pure cranberry juice in the US? My wife drinks it all of the time and she's never complained that it's too sour. I've not noticed that either. Apparently, for females it's also good to prevent cystitis.

Hey, we can even get it in the UK:

http://www.dooyoo.co.uk/drinks/suncrest-guava-juice-drink/


But I like the look of those 'Products similar to Suncrest Guava Juice Drink' further down the page! Who the hell writes their algorithms?!

Poseurs and amateurs, obviously. There is so much bad software around! If I didn't know better I would say that it reproduces itself.

I also have a guava tree in the ground that gives us lots of fruit. They're one of the easiest trees to grow. Drop a fruit onto the soil in a pot and in a year you will have fifty trees! They thrive on neglect. We can get juice in the local store, don't know the brand, but can also get it mixed with passion fruit and orange juice.